<%@ page language="java" import="java.util.*" pageEncoding="utf-8"%>
<%
String path = request.getContextPath();
String basePath = request.getScheme()+"://"+request.getServerName()+":"+request.getServerPort()+path+"/";
%>
<div class="pageContent">
	<form method="post"  action="<%=basePath %>customer/add_history.action" 
		class="pageForm required-validate" onsubmit="return validateCallback(this);">
		<div class="pageFormContent" layoutH="56">
			
			  <p>
				<label>客户名：</label>
				<input name="customer.cname" class="required" type="text" size="16"  maxlength="32" value="" />
				<a class="btnLook" href="<%=basePath %>customer/customerQuery.jsp" lookupgroup="customer">查找带回</a>
			</p>
			<dl class="nowrap">
				<dt>药物过敏史：</dt>
				<dd><textarea rows="2" cols="80" name="history.drugAllery" class="textInput"></textarea></dd>
				</dl>
				<dl class="nowrap">
				<dt>危险环境接触史：</dt>
				<dd><textarea rows="2" cols="80" name="history.envExplosure" class="textInput"></textarea></dd>
			</dl><dl class="nowrap">
				<dt>既往病史：</dt>
				<dd><textarea rows="2" cols="80" name="history.pastIllness" class="textInput"></textarea></dd>
			</dl><dl class="nowrap">
				<dt>既往手术：</dt>
				<dd><textarea rows="2" cols="80" name="history.pastSurgery" class="textInput"></textarea></dd>
			</dl><dl class="nowrap">
				<dt>既往外伤：</dt>
				<dd><textarea rows="2" cols="80" name="history.pastInjury" class="textInput"></textarea></dd>
				</dl><dl class="nowrap">
				<dt>既往输血：</dt>
				<dd><textarea rows="2" cols="80" name="history.pastTransfusion" class="textInput"></textarea></dd>
				</dl>
				<p>
				<input name="customer.customerId" class="required" type="hidden" size="16"  maxlength="32" value="" />
			</p>
		</div>
		<div class="formBar">
			<ul>
				<!--<li><a class="buttonActive" href="javascript:;"><span>保存</span></a></li>-->
				<li><div class="buttonActive"><div class="buttonContent"><button type="submit">保存</button></div></div></li>
				<li>
					<div class="button"><div class="buttonContent"><button type="button" class="close">取消</button></div></div>
				</li>
			</ul>
		</div>
	</form>
</div>
